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Higher-Than-Expected Burden of Alcohol-Related Liver Diseases During COVID-19 Pandemic in the USA, with a Tapering Trend

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Abstract

Background

Coronavirus disease 2019 (COVID-19) pandemic has led to an increase in alcohol-related liver disease (ALD). The aim of this study was to evaluate the magnitude of ALD hospitalization surge during the pandemic in the USA.

Main Measures

A retrospective trend analysis of adult hospitalizations for ALD at acute care hospitals across the USA in 2016–2020 was conducted. Hospitalizations were identified using the International Classification of Diseases 10 codes for ALD and non-alcoholic–related liver disease. Outcomes measured included the predicted monthly volume of hospitalizations for ALD and inpatient mortality rates.

Key Results

During the 2020 pandemic, monthly ALD hospitalizations reached 10,247 representing a 20.7% increase compared to pre-pandemic monthly average of 8490. Additional 4163 ALD hospitalizations occurred during the pandemic, in addition to a pre-pandemic uptrend. The peak of excess ALD hospitalizations was from May to October (monthly excess of 1138) decreasing to monthly excess of 280 in November and December. The excess increase in ALD hospitalizations was primarily observed in young adults, totaling 5256 cases affecting both male (2101 excess cases) and females (2041 excess cases). The age-standardized monthly mortality rate during the pandemic was notably higher than expected at 0.9% (95% CI 0.4 to 1.4%).

Conclusions

The COVID-19 pandemic led to a significant increase in ALD hospitalizations, above and beyond the pre-existing upward trend, which tapered towards the end of 2020, suggesting a possible decline in the pandemic’s impact. The excess increase in ALD hospitalizations was observed primarily in young adults and affected both males and females. These findings highlight the need for further attention to the long-term consequences of the pandemic.

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Abbreviations

aOR:

Adjusted odds ratio

COVID-19:

Coronavirus disease 2019

ICD:

International Classification of Diseases

IQR:

Interquartile range

NIS:

National Inpatient Sample

PCS:

Procedure Coding System

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Author notes

  1. Yichen Wang and Yuting Huang contributed equally.

Authors and Affiliations

  1. Division of Hospital Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Yichen Wang MD

  2. Division of Gastroenterology & Hepatology, Mayo Clinic in Florida, Jacksonville, FL, USA

    Yuting Huang MBBS, PhD

  3. Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

    Chenyu Sun MD

  4. Department of Medicine, NYU Grossman School of Medicine, New York City, NY, USA

    Howard Chung MD

  5. Department of Transplantation, Mayo Clinic in Florida, Jacksonville, FL, USA

    C. Burcin Taner MD & Liu Yang MBBS

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Correspondence to Liu Yang MBBS.

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Wang, Y., Huang, Y., Sun, C. et al. Higher-Than-Expected Burden of Alcohol-Related Liver Diseases During COVID-19 Pandemic in the USA, with a Tapering Trend. J GEN INTERN MED (2024). https://doi.org/10.1007/s11606-023-08594-6

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